"I'm very hopeful we'll make some progress, that we'll get something on the table we can talk about," Clark said after the news conference. "This is a no-win situation."

Clark said that while the hospital -- Kauai's lone full-service facility -- has been providing all its services with the help of replacement nurses, it is a bad situation for the island to see their neighbors out on the picket lines.

"We're willing to listen to what the union has to say and make a determination," Clark said. "There's always room to negotiate."

But Aggie Pigao Cadiz, Hawaii Nurses Association executive director, said the striking nurses have always been willing to negotiate. It is the administration that has been dragging its feet, she said.

"Last time, the night before (the strike vote), the employers said, 'Take it or leave it,'" Pigao Cadiz said. The union voted "and said, 'Leave it.'"

Clark said there are three issues still on the table: the staff-to-patient ratio, and two issues regarding on-call policies for nurses in the operating room.

Clark said that while the hospital is willing to discuss creation of a committee to look into a different staff-to-patient ratio, a $50,000 software system to handle that ratio is unacceptable when the hospital is continuing to lose money. She said the administration has made concessions on the on-call issue.

Pigao Cadiz has said, however, that the ratio currently in place does not work and that it makes patient care more difficult for the nurses at Wilcox.

She said the replacement nurses flown in from the mainland have been extremely expensive as well, and the money would have been better suited going to securing better patient care rather than fighting the nurses.